MEDICARE: CRESCENT CITY SCHOOLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1770823965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT CITY SCHOOLS

Provider Business Mailing Address
First Line	:	2013 GENERAL MEYER AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-1533
Country	:	US
Telephone Number	:	504-708-4136
Fax Number	:	504-617-7704

Provider Business Practice Location Address
First Line	:	3819 HERSCHEL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6819
Country	:	US
Telephone Number	:	504-941-1810
Fax Number	:	504-617-7704

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. CHRISTOPHER HINES
Credential	:
Telephone Number	:	504-708-4136

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	02/25/2013

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